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1. A PROSPECTIVE, SINGLE ARM STUDY OF THE SAFETY, EFFICACY AND PATIENT SATISFACTION OF A NOVEL PATIENT-CENTRIC IMPLANTABLE TIBIAL NEUROMODULATION SYSTEM FOR THE TREATMENT OF URINARY URGE INCONTINENCE IN WOMEN

Author

Tooz-Hobson, P, primary, Sutherland, S, additional, Amundsen, C, additional, McCrery, R, additional, Kean, E, additional, De Wachter, S, additional, Benson, K, additional, Martens, F, additional, Ferrrante, K, additional, Padron, O, additional, Giusto, L, additional, Robertson, K, additional, Pezzella, A, additional, Dmochowski, R, additional, Aharonson-Raz, K, additional, Baruch, S, additional, Heesakkers, J, additional, and Digesu, A, additional

Published
2023
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3. 219 - A PROSPECTIVE, SINGLE ARM STUDY OF THE SAFETY, EFFICACY AND PATIENT SATISFACTION OF A NOVEL PATIENT-CENTRIC IMPLANTABLE TIBIAL NEUROMODULATION SYSTEM FOR THE TREATMENT OF URINARY URGE INCONTINENCE IN WOMEN

Author

Tooz-Hobson, P, Sutherland, S, Amundsen, C, McCrery, R, Kean, E, De Wachter, S, Benson, K, Martens, F, Ferrrante, K, Padron, O, Giusto, L, Robertson, K, Pezzella, A, Dmochowski, R, Aharonson-Raz, K, Baruch, S, Heesakkers, J, and Digesu, A

Published
2023
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9. Risk factors for hospital readmission of elderly patients

Author

Franchi, C, Nobili, A, Mari, D, Tettamanti, M, Djade, Cd, Pasina, L, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Mannucci, Pm, Reposi, Investigators, Pier, Mm, Alessandro, N, Salvatore, C, Spirito, V, Noce, D, Bonazzi, J, Lombardo, R, Sparacio, E, Alborghetti, S, De Vittorio, L, Paolisso, G, Rizzo, Mr, Laieta, Mt, Brignone, C, Roberto, T, Persico, Marcello, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Fenoglio, L, Bracco, C, Gasbarrone, L, Porcari, P, Famularo, G, Sajeva, Mr, Maniscalco, G, Gunelli, M, Tirotta, D, Realdi, G, Baritussio, A, Frassoni, F, Delsignore, R, Baroni, Mc, Zardo, M, Volpato, S, Fotini, S, Manfredini, R, Longhini, C, Molino, C, Incasa, E, Guarnieri, G, Zanetti, M, Spalluti, A, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Tuttolomondo, A, Di Sciacca, R, Antonaci, S, Vella, F, Marseglia, A, Centonze, V, Modeo, Me, Palasciano, G, Pugliese, S, Capobianco, C, Murialdo, G, Bovio, M, Laghi Pasini, F, Capecchi, Pl, Bicchi, M, Nuti, R, Valenti, R, Capodarca, C, Auteri, A, Pasqui, Al, Puccetti, L, Olivieri, O, Stanzial, Am, Agnelli, G, Macura, A, Mannarino, E, Lupattelli, G, Rondelli, P, Serra, Mg, Musca, G, Cuccurullo, O, Cappellini, Md, Fabio, G, Motta, I, Cantoni, F, Fargion, S, Bonara, P, Bulgheroni, M, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Monzani, V, Savojardo, V, Folli, C, Dionigi Rossi, P, Ziglioli, E, Lilleri, Ms, Selmi, C, Meda, F, Cazzaniga, M, Monti, V, Balduini, Cl, Bertolino, G, Dezzani, L, Cavallo, P, Corazza, Gr, Miceli, E, Secchi, Mb, Wu, Sc, Sofia, L, Anastasio, L, Carbone, M, Bertucci, L, De Feudis, L, Traisci, G, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Ronchi, E, Buratti, A, Tognin, T, Bertolini, D, Liberato, Nl, Bernasconi, G, Nardo, B, Venco, A, Guasti, L, Maroni, L, Castiglioni, L, Casella, G, Vanoli, M, Grignani, G, Mancuso, G, Tavella, R, Persico, R, Cicardi, M, Sandrone, G, Magenta, M, Perego, F, Meroni, Mr, Rozzini, R, Falanga, L, Giordano, A, Menardo, G, Bottone, S, Sferrazzo, E, Tassara, R, Melis, D, Rebella, L, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Di Todaro, F, Nielsen, I, Giusto, L, Semplicini, A, Gottardo, L, Delitala, G, Carta, S, Atzori, S, Rosei, Ea, Rizzoni, D, Castoldi, L, Altomare, E, Serviddio, G, Salvatore, S, Fera, G, Di Luca ML, Renna, D, Picardi, A, Mazzarelli, C, Vespasiani Gentilucci, U, De Vincentis, A, Hila, D, Bernardi, M, Li Bassi, S, Santi, L, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Serra, P, Fontana, V, Falcone, M, Violi, F, Basili, S, Perri, L, Silveri, Ng, De Marco, G, Giupponi, B, Landolfi, R, Grieco, A, Gallo, A, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Bonometti, F, Loria, P, Ballestri, S, Becchi, Ma, Bolondi, L, Rasciti, L, Serio, I, Gualandi, S, Romanelli, G, Carulli, N, Rondinella, S, Giannico, I, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Sacco, A, Bonelli, A, Dentamaro, G, Micale, G, Delitalia, G, Deidda, S, Cuccuru, Lm, Benetti, G, Quagliolo, M, Centenaro, Gr, Macchini, L, Perciccante, A, Coralli, A, Realdi, A, Cricco, L, Morabito, C, Fava, R, Fiorentini, A, Tofi, C., Franchi C, Nobili A, Mari D, Tettamanti M, Djade CD, Pasina L, Salerno F, Corrao S, Marengoni A, Iorio A, Marcucci M, Mannucci PM, REPOSI Investigators [.., Bernardi M, Bolondi L, ], Franchi, C, Nobili, A, Mari, D, Tettamanti, M, Djade, CD, Pasina, L, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Mannucci, PM, Tuttolomondo, A, Mansueto, P, Franchi, Carlotta, Nobili, Alessandro, Mari, Daniela, Tettamanti, Mauro, Djade, Codjo D., Pasina, Luca, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Iorio, Alfonso, Marcucci, Maura, Mannucci, Pier Mannuccio, Rizzo, Maria Rosaria, Carlotta, Franchi, Alessandro, Nobili, Daniela, Mari, Mauro, Tettamanti, Codjo D., Djade, Luca, Pasina, Francesco, Salerno, Salvatore, Corrao, Alessandra, Marengoni, Alfonso, Iorio, Maura, Marcucci, Pier Mannuccio, Mannucci, and Zanetti, Michela

Subjects
Male, Settore MED/09 - Medicina Interna, Time Factors, Risk factors, internal medicine, Geriatric patient, hospital admission, Logistic regression, Elderly, Hospital readmission, Internal medicine and geriatric wards, 80 and over, Aged, Aged, 80 and over, Female, Geriatrics, Hospital Departments, Humans, Internal Medicine, Patient Readmission, Risk Factors, Medical diagnosis, Aged, Aged, 80 and over, Female, Geriatrics, Hospital Departments, Humans, Internal Medicine, Male, Patient Readmission, statistics /&/ numerical data, Risk Factors, Time Factors, Univariate analysis, vascular disease, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, Ageing, readmission, statistics /&/ numerical data, Hospital Department, liver disease, Human, medicine.medical_specialty, Time Factor, MEDLINE, Hospital readmission, Internal medicine and geriatric wards, Risk factors, Elderly, elderly patients, NO, medicine, Registry Politerapie SIMI (REPOSI), Adverse effect, business.industry, Risk Factor, Univariate, medicine.disease, Comorbidity, elderly, hospital readmission, risk factors, internal medicine and geriatric wards, Internal medicine and geriatric ward, Emergency medicine, business, Geriatric
Abstract

Background: The aim of this study was to identify which factors were associated with a risk of hospital readmission within 3 months after discharge of a sample of elderly patients admitted to internal medicine and geriatric wards. Methods: Of the 1178 patients aged 65 years or more and discharged from one of the 66 wards of the 'Registry Politerapie SIMI (REPOSI)' during 2010, 766 were followed up by phone interview 3 months after discharge and were included in this analysis. Univariate and multivariate logistic regression models were used to evaluate the association of several variables with rehospitalization within 3 months from discharge. Results: Nineteen percent of patients were readmitted at least once within 3 months after discharge. By univariate analysis in-hospital clinical adverse events (AEs), a previous hospital admission, number of diagnoses and drugs, comorbidity and severity index (according to Cumulative Illness Rating Scale-CIRS), vascular and liver diseases with a level of impairment at discharge of 3 or more at CIRS were significantly associated with risk of readmission. Multivariate logistic regression analysis showed that only AEs during hospitalization, previous hospital admission, and vascular and liver diseases were significantly associated with the likelihood of readmission. Conclusions: The results demonstrate the need for increased medical attention towards elderly patients discharged from hospital with characteristics such as AEs during the hospitalization, previous admission, vascular and liver diseases. © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Published
2013
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10. Factors affecting adherence to guidelines for antithrombotic therapy in elderly patients with atrial fibrillation admitted to internal medicine wards

Author

Marcucci, M, Iorio, A, Nobili, A, Tettamanti, M, Pasina, L, Marengoni, A, Salerno, F, Corrao, S, Mannucci, Pm, Tedeschi A, REPOSI Investigators., Rossio, R, Moreo, G, Ferrari, B, Mammarella, A, Raparelli, V, Rondinella, S, Giannico, I, Rasciti, L, Gualandi, S, Monzani, V, Savojardo, V, Fabio, G, Colombo, S, Quercioli, A, Barreca, A, Durante-Mangoni, E, Pinto, D, Incasa, E, Rizzoli, E, Vanoli, M, Casella, G, Musca, G, Cuccurullo, O, Famularo, G, Sajeva, Mr, Picardi, A, Hila, D, Rozzini, R, Giordano, A, Bonelli, A, Dentamaro, G, Gobbo, G, Cazzaniga, M, Gaudenzi, P, Giusto, L, Rizzoni, D, Castoldi, L, Mari, D, Micale, G, Altomare, E, Serviddio, G, Longhini, C, Molino, C, Deidda, S, Cuccuru, Lm, Quagliolo, M, Centenaro, Gr, Pasqui, Al, Puccetti, L, Bertolino, G, Cavallo, P, Bertolini, D, Liberato, Nl, Perciccante, A, Coralli, A, Anastasio, L, Bertucci, L, Macura, A, Matino, D, Morabito, C, Fava, R, Tuttolomondo, A, Di Sciacca, R, Semplicini, A, Magagnotti, G, Fiorentini, A, Tofi, C, Cagnoni, C, Manucra, A, Romanelli, G, Cortellaro, M, Meroni, Mr, Rossi, Dp, Vergani, C., Marcucci, M, Iorio, A, Nobili, A, Tettamanti, M, Pasina, L, Marengoni, A, Salerno, F, Corrao, S, Mannucci, PM, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Mammarella, A, Raparelli, V, Rondinella, S, Giannico, I, Rasciti, L, Gualandi, S, Monzani, V, Savojardo, V, Fabio, G, Colombo, S, Quercioli, A, Barreca, A, Durante-Mangoni, E, Pinto, D, Incasa, E, Rizzoli, E, Vanoli, M, Casella, G, Musca, G, Cuccurullo, O, Famularo, G, Sajeva, MR, Picardi, A, Hila, D, Rozzini, R, Giordano, A, Bonelli, A, Dentamaro, G, Gobbo, G, Cazzaniga, M, Gaudenzi, P, Giusto, L, Rizzoni, D, Castoldi, L, Mari, D, Micale, G, Altomare, E, Serviddio, G, Longhini, C, Molino, C, Deidda, S, Cuccuru, LM, Quagliolo, M, Centenaro, GR, Pasqui, AL, Puccetti, L, Bertolino, G, Cavallo, P, Bertolini, D, Liberato, NL, Perciccante, A, Coralli, A, Anastasio, L, Bertucci, L, Macura, A, Matino, D, Morabito, C, Fava, R, Tuttolomondo, A, Di Sciacca, R, Semplicini, A, Magagnotti, G, Fiorentini, A, Tofi, C, Cagnoni, C, Manucra, A, Romanelli, G, Cortellaro, M, Meroni, MR, Rossi, DP, and Vergani, C

Subjects
Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Vitamin K, antithrombotic therapy, NO, Antithrombotic prophylaxis, Atrial fibrillation, Platelet agents, Vitamin K antagonists, Fibrinolytic Agents, Risk Factors, Internal medicine, Antithrombotic, Internal Medicine, medicine, Humans, atrial fibrillation, Registries, Medical prescription, Stroke, Aged, Retrospective Studies, Aged, 80 and over, Antithrombotic prophylaxis, Atrial fibrillation, Platelet agents, Vitamin K antagonists, guidelines, Aspirin, business.industry, antithrombotic prophylaxis, platelet agents, vitamin k antagonists, Retrospective cohort study, medicine.disease, Intracranial Embolism, Italy, Platelet aggregation inhibitor, Female, Guideline Adherence, business, guideline, Platelet Aggregation Inhibitors, Fibrinolytic agent, medicine.drug
Abstract

Introduction Current guidelines for ischemic stroke prevention in atrial fibrillation or flutter (AFF) recommend Vitamin K antagonists (VKAs) for patients at high-intermediate risk and aspirin for those at intermediate-low risk. The cost-effectiveness of these treatments was demonstrated also in elderly patients. However, there are several reports that emphasize the underuse of pharmacological prophylaxis of cardio-embolism in patients with AFF in different health care settings. Aims To evaluate the adherence to current guidelines on cardio-embolic prophylaxis in elderly (> 65 years old) patients admitted with an established diagnosis of AFF to the Italian internal medicine wards participating in REPOSI registry, a project on polypathologies/polytherapies stemming from the collaboration between the Italian Society of Internal Medicine and the Mario Negri Institute of Pharmacological Research; to investigate whether or not hospitalization had an impact on guidelines adherence; to test the role of possible modifiers of VKAs prescription. Methods We retrospectively analyzed registry data collected from January to December 2008 and assessed the prevalence of patients with AFF at admission and the prevalence of risk factors for cardio-embolism. After stratifying the patients according to their CHADS 2 score the percentage of appropriateness of antithrombotic therapy prescription was evaluated both at admission and at discharge. Univariable and multivariable logistic regression models were employed to verify whether or not socio-demographic (age > 80 years, living alone) and clinical features (previous or recent bleeding, cranio-facial trauma, cancer, dementia) modified the frequency and modalities of antithrombotic drugs prescription at admission and discharge. Results Among the 1332 REPOSI patients, 247 were admitted with AFF. At admission, CHADS 2 score was ≥ 2 in 68.4% of patients, at discharge in 75.9%. Among patients with AFF 26.5% at admission and 32.8% at discharge were not on any antithrombotic therapy, and 43.7% at admission and 40.9% at discharge were not taking an appropriate therapy according to the CHADS 2 score. The higher the level of cardio-embolic risk the higher was the percentage of antiplatelet- but not of VKAs-treated patients. At admission or at discharge, both at univariable and at multivariable logistic regression, only an age > 80 years and a diagnosis of cancer, previous or active, had a statistically significant negative effect on VKAs prescription. Moreover, only a positive history of bleeding events (past or present) was independently associated to no VKA prescription at discharge in patients who were on VKA therapy at admission. If heparin was considered as an appropriate therapy for patients with indication for VKAs, the percentage of patients admitted or discharged on appropriate therapy became respectively 43.7% and 53.4%. Conclusion Among elderly patients admitted with a diagnosis of AFF to internal medicine wards, an appropriate antithrombotic prophylaxis was taken by less than 50%, with an underuse of VKAs prescription independently of the level of cardio-embolic risk. Hospitalization did not improve the adherence to guidelines.

Published
2010

11. In-hospital death and adverse clinical events in elderly patients according to disease clustering: the REPOSI study. Marengoni A

Author

Marengoni, A, Bonometti, F, Nobili, A, Tettamanti, M, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Mannucci, PM, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Mammarella, A, Raparelli, V, Rondinella, S, Giannico, I, Rasciti, L, Gualandi, S, Monzani, V, Savojardo, V, Fabio, G, Colombo, S, Quercioli, A, Barreca, A, Durante Mangoni, E, Pinto, D, Incasa, E, Rizzoli, E, Vanoli, M, Casella, G, Musca, G, Cuccurullo, O, Famularo, G, Sajeva, R, Picardi, A, Hila, D, Rozzini, R, Giordano, A, Bonelli, A, Dentamaro, G, Gobbo, G, Cazzaniga, M, Gaudenzi, P, Giusto, L, Rizzoni, D, Castoldi, L, Mari, D, Micale, G, Altomare, E, Serviddio, G, Longhini, C, Molino, C, Deidda, S, Cuccuru, LM, Quagliolo, M, Centenaro, GR, Pasqui, AL, Puccetti, L, Bertolino, G, Cavallo, P, Bertolini, D, Liberato, NL, Perciccante, A, Coralli, A, Anastasio, L, Bertucci, L, Agnelli, G, Macura, A, Morabito, C, Fava, R, Di Sciacca, R, Macchini, L, Realdi, A, Fiorentini, A, Tofi, C, Cagnoni, C, Manucra, A, Romanelli, G, Cortellaro Meroni, MR, Rossi, DP, Vergani, C., TUTTOLOMONDO, Antonino, Marengoni, A, Bonometti, F, Nobili, A, Tettamanti, M, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Mannucci, PM, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Mammarella, A, Raparelli, V, Rondinella, S, Giannico, I, Rasciti, L, Gualandi, S, Monzani, V, Savojardo, V, Fabio, G, Colombo, S, Quercioli, A, Barreca, A, Durante Mangoni, E, Pinto, D, Incasa, E, Rizzoli, E, Vanoli, M, Casella, G, Musca, G, Cuccurullo, O, Famularo, G, Sajeva, R, Picardi, A, Hila, D, Rozzini, R, Giordano, A, Bonelli, A, Dentamaro, G, Gobbo, G, Cazzaniga, M, Gaudenzi, P, Giusto, L, Rizzoni, D, Castoldi, L, Mari, D, Micale, G, Altomare, E, Serviddio, G, Longhini, C, Molino, C, Deidda, S, Cuccuru, LM, Quagliolo, M, Centenaro, GR, Pasqui, AL, Puccetti, L, Bertolino, G, Cavallo, P, Bertolini, D, Liberato, NL, Perciccante, A, Coralli, A, Anastasio, L, Bertucci, L, Agnelli, G, Macura, A, Morabito, C, Fava, R, Tuttolomondo, A, Di Sciacca, R, Macchini, L, Realdi, A, Fiorentini, A, Tofi, C, Cagnoni, C, Manucra, A, Romanelli, G, Cortellaro Meroni, MR, Rossi, DP, and Vergani, C

Subjects
Settore MED/09 - Medicina Interna, elderly, in-hospital death
Abstract

OBJECTIVE: The aim of the study was to recognize clusters of diseases among hospitalized elderly and to identify groups of patients at risk of in-hospital death and adverse clinical events according to disease clustering. METHOD: This was a cross-sectional study conducted in 38 internal medicine and geriatric wards in Italy participating in the Registro Politerapie SIMI (REPOSI) study during 2008. The subjects were 1,332 inpatients aged 65 years or older. Clusters of diseases (i.e., two or more co-occurrent diseases) were identified using the odds ratios (OR) for the associations between pairs of conditions, followed by cluster analysis. Logistic regression models were used to evaluate the effect of disease clusters on in-hospital death and adverse clinical events. RESULTS: A total of 86.7% of the patients were discharged, 8.3% were transferred to another hospital unit, and 5.0% died during hospitalization; 36.4% of the patients had at least one adverse clinical event. Patients affected by the clusters, including heart failure (HF) and either chronic renal failure (CRF) or chronic obstructive pulmonary disease, had a significant association with in-hospital death (OR, 4.3;95% confidence interval [CI], 1.6-11.5; OR, 2.9; 95% CI, 1.1-8.3, respectively), as well as patients affected by CRF and anemia (OR, 6.1; 95% CI, 2.3-16.2). The cluster including HF and CRF was also associated with adverse clinical events (OR, 3.5; 95% CI, 1.5-7.8). The effect of both HF and CRF and anemia and CRF on in-hospital death was additive. CONCLUSION: Several groups of older patients at risk of in-hospital death and adverse clinical events were identified according to disease clustering. Knowledge of the relationship among co-occurring diseases may help developing strategies to improve clinical practice and preventative interventions.

Published
2010

12. Comparison of Disease Clusters in Two Elderly Populations Hospitalized in 2008 and 2010

Author

Marengoni, A, Nobili, A, Pirali, C, Tettamanti, M, Pasina, L, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Franchi, C, Mannucci, Pm, Reposi, Investigators, Pier Mannucci, M, Spirito, V, Noce, D, Bonazzi, J, Lombardo, R, Sparacio, E, Alborghetti, S, De Vittorio, L, Djade, Cd, Paolisso, G, Rizzo, Mr, Laieta, Mt, Roberto, T, Persico, Marcello, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Fenoglio, L, Brignone, C, Bracco, C, Gasbarrone, L, Porcari, P, Famularo, G, Sajeva, Mr, Maniscalco, G, Gunelli, M, Tirotta, D, Realdi, G, Baritussio, A, Frassoni, F, Delsignore, R, Baroni, Mc, Zardo, M, Volpato, S, Fotini, S, Manfredini, R, Longhini, C, Molino, C, Incasa, E, Guarnieri, G, Zanetti, M, Spalluti, A, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Tuttolomondo, A, Di Sciacca, R, Antonaci, S, Vella, F, Marseglia, A, Centonze, V, Modeo, Me, Palasciano, G, Pugliese, S, Capobianco, C, Murialdo, G, Bovio, M, Pasini, Fl, Capecchi, Pl, Bicchi, M, Nuti, R, Valenti, R, Capodarca, C, Auteri, A, Pasqui, Al, Puccetti, L, Olivieri, O, Stanzial, Am, Agnelli, G, Macura, A, Mannarino, E, Lupattelli, G, Rondelli, P, Serra, Mg, Musca, G, Cuccurullo, O, Cappellini, Md, Fabio, G, Motta, I, Cantoni, F, Fargion, S, Bonara, P, Bulgheroni, M, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Mari, D, Rossi, Pd, Ziglioli, E, Vergani, C, Lilleri, Ms, Podda, M, Selmi, C, Meda, F, Cazzaniga, M, Monti, V, Balduini, Cl, Bertolino, G, Dezzani, L, Cavallo, P, Corazza, Gr, Miceli, E, Secchi, Mb, Wu, Sc, Balsamo, C, Anastasio, L, Sofia, L, Carbone, M, Bertucci, L, Valentia, V, Traisci, G, De Feudis, L, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Ronchi, E, Buratti, A, Tognin, T, Bertolini, D, Liberato, Nl, Bernasconi, G, Nardo, B, Venco, A, Guasti, L, Maroni, L, Castiglioni, L, Vanoli, M, Grignani, G, Casella, G, Mancuso, G, Tavella, R, Persico, R, Cicardi, M, Sandrone, G, Cortellaro, M, Magenta, M, Perego, F, Meroni, Mr, Rozzini, R, Falanga, L, Giordano, A, Menardo, G, Bottone, S, Sferrazzo, E, Tassara, R, Melis, D, Rebella, L, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Di Todaro, F, Nielsen, I, Giusto, L, Semplicini, A, Gottardo, L, Delitala, G, Carta, S, Atzori, S, Rosei, Ea, Rizzoni, D, Castoldi, L, Altomare, E, Serviddio, G, Salvatore, S, Fera, G, Di Luca ML, Renna, D, Picardi, A, Mazzarelli, C, Gentilucci, Uv, De Vincentis, A, Hila, D, Bernardi, M, Li Bassi, S, Santi, L, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Serra, P, Fontana, V, Falcone, M, Violi, F, Basili, S, Perri, L, Silveri, Ng, De Marco, G, Giupponi, B, Landolfi, R, Grieco, A, Gallo, A, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Ballestri, S, Becchi, Ma, Bellettini, E, Bolondi, L, Rasciti, L, Serio, I, Gualandi, S, Romanelli, G, Bonometti, F, Carulli, N, Rondinella, S, Giannico, I, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Sacco, A, Bonelli, A, Dentamaro, G, Micale, G, Delitalia, G, Deidda, S, Cuccuru, Lm, Benetti, G, Quagliolo, M, Centenaro, Gr, Perciccante, A, Coralli, A, Morabito, C, Fava, R, Macchini, L, Realdi, A, Cricco, L, Fiorentini, A, Tofi, C., Marengoni A, Nobili A, Pirali, C, Tettamanti, M, Pasina, L, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Franchi, C, Mannucci, Pm, Investigators, Reposi, Zanetti, Michela, Marengoni, A., Nobili, A., Pirali, C., Tettamanti, M., Pasina, L., Salerno, F., Corrao, S., Iorio, A., Marcucci, M., Franchi, C., Mannucci, P. M, Rizzo, Mr, Marengoni A, Nobili A, Pirali C, Tettamanti M, Pasina L, Salerno F, Corrao S, Iorio A, Marcucci M, Franchi C, Mannucci PM, REPOSI Investigators [.., Bernardi M, Bolondi L, ], Mannucci, P., and Mansueto, P.

Subjects
Registrie, Male, Aging, Cirrhosis, Settore MED/09 - Medicina Interna, Time Factors, hispitalization, Gerontology, aging populations, atterns of multimorbidity, diseases in the elderly population, Health care, 80 and over, Prevalence, Chronic diseases, Cluster analysis, Hospitalized elderly, Registries, aging population, Aged, 80 and over, education.field_of_study, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, Hospitalization, Italy, elderly, disease clusters, Female, hospitalized, Human, medicine.medical_specialty, Time Factor, Anemia, MULTIMORBIDITY, Population, MEDLINE, Malignancy, Diabetes mellitus, Internal medicine, medicine, Multimorbidity, Humans, education, Aged, Chronic Disease, Cluster Analysis, Geriatrics and Gerontology, Cluster Analysi, business.industry, medicine.disease, Physical therapy, disease cluster, business
Abstract

Background: As chronicity represents one of the major challenges in the healthcare of aging populations, the understanding of how chronic diseases distribute and co-occur in this part of the population is needed. Objectives: The aims of this study were to evaluate and compare patterns of diseases identified with cluster analysis in two samples of hospitalized elderly. Methods: Data were obtained from the multicenter ‘Registry Politerapie SIMI (REPOSI)' that included people aged 65 or older hospitalized in internal medicine and geriatric wards in Italy during 2008 and 2010. The study sample from the first wave included 1,411 subjects enrolled in 38 hospitals wards, whereas the second wave included 1,380 subjects in 66 wards located in different regions of Italy. To analyze patterns of multimorbidity, a cluster analysis was performed including the same diseases (19 chronic conditions with a prevalence >5%) collected at hospital discharge during the two waves of the registry. Results: Eight clusters of diseases were identified in the first wave of the REPOSI registry and six in the second wave. Several diseases were included in similar clusters in the two waves, such as malignancy and liver cirrhosis; anemia, gastric and intestinal diseases; diabetes and coronary heart disease; chronic obstructive pulmonary disease and prostate hypertrophy. Conclusion: These findings strengthened the idea of an association other than by chance of diseases in the elderly population.

Published
2013

13. In-hospital death according to dementia diagnosis in acutely ill elderly patients: the REPOSI study

Author

Marengoni, A, Corrao, S, Nobili, A, Tettamanti, M, Pasina, L, Salerno, F, Iorio, A, Marcucci, M, Bonometti, F, Mannucci, Pm, SIMI Investigators Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Mammarella, A, Raparelli, V, Rondinella, S, Giannico, I, Rasciti, L, Gualandi, S, Monzani, V, Savojardo, V, Fabio, G, Colombo, S, Quercioli, A, Barreca, A, Durante-Mangoni, E, Pinto, D, Incasa, E, Rizzioli, E, Vanoli, M, Casella, G, Musca, G, Cuccurullo, O, Famularo, G, Sajeva, Mr, Picardi, A, Hila, D, Rozzini, R, Giordano, A, Bonelli, A, Dentamaro, G, Gobbo, G, Cazzaniga, M, Gaudenzi, P, Giusto, L, Rizzoni, D, Castoldi, L, Mari, D, Micale, G, Altomare, E, Serviddio, G, Longhini, C, Molino, C, Deidda, S, Cuccuru, Lm, Quagliolo, M, Centenaro, Gr, Pasqui, Al, Puccetti, L, Bertolino, G, Cavallo, P, Bertolini, D, Liberato, Nl, Perciaccante, A, Coralli, A, Anastasio, L, Bertucci, L, Agnelli, G, Macura, A, Morabito, C, Fava, R, Tuttolomondo, A, Di Sciacca, R, Macchini, L, Realdi, A, Fiorentini, A, Tofi, C, Cagnoni, C, Manucra, A, Romanelli, G, Cortellaro, M, Meroni, Mr, Rossi, Dp, Vergani, C, Ogliari, G, Marengoni, A, Corrao, S, Nobili, A, Tettamanti, M, Pasina, L, Salerno, F, Iorio, A, Marcucci, M, Bonometti, F, Mannucci, PM, and SIMI Investigators

Subjects
Male, medicine.medical_specialty, Pediatrics, Settore MED/09 - Medicina Interna, MEDLINE, Charlson index, Logistic regression, NO, older patient, Sex Factors, Acute illnesses, Dementia, Hospitalization, Mortality, Older patients, mental disorders, medicine, Dementia, Humans, Dementia diagnosis, Hospital Mortality, Intensive care medicine, Aged, In hospital death, Aged, 80 and over, business.industry, acute illnesses, Confounding, Age Factors, risk of death, medicine.disease, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, mortality, older patients, acute illnesse, Psychiatry and Mental health, Pneumonia, hospital admission, Logistic Models, Acute Disease, Female, Geriatrics and Gerontology, business, dementia, hospitalization
Abstract

The aim of the study was to explore the association of dementia with in-hospital OBJECTIVE:The aim of the study was to explore the association of dementia with in-hospital death in acutely ill medical patients. METHODS: Thirty-four internal medicine and 4 geriatric wards in Italy participated in the Registro Politerapie SIMI-REPOSI-study during 2008. One thousand three hundred and thirty two in-patients aged 65 years or older were enrolled. Logistic regression models were used to evaluate the association of dementia with in-hospital death. Socio-demographic characteristics, morbidity (single diseases and the Charlson Index), number of drugs, and adverse clinical events during hospitalization were considered as potential confounders. RESULTS: One hundred and seventeen participants were diagnosed as being affected by dementia. Patients with dementia were more likely to be women, older, to have cerebrovascular diseases, pneumonia, and a higher number of adverse clinical events during hospitalization. The percentage of patients affected by dementia who died during hospitalization was higher than that of patients without dementia (9.4 versus 4.9%). After multiadjustment, the diagnosis of dementia was associated with in-hospital death (OR = 2.1; 95% CI = 1.0-4.5). Having dementia and at least one adverse clinical event during hospitalization showed an additive effect on in-hospital mortality (OR = 20.7; 95% CI = 6.9-61.9). CONCLUSIONS: Acutely ill elderly patients affected by dementia are more likely to die shortly after hospital admission. Having dementia and adverse clinical events during hospital stay increases the risk of death.

Published
2010

14. In-hospital death and adverse clinical events in elderly patients according to disease clustering: The REPOSI study

Author

Marengoni, A, Bonometti, F, Nobili, A, Tettamanti, M, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Mannucci, Pm, Tedeschi A, Italian Society of Internal Medicine (SIMI) Investigators., Rossio, R, Moreo, G, Ferrari, B, Mammarella, A, Raparelli, V, Rondinella, S, Giannico, I, Rasciti, L, Gualandi, S, Monzani, V, Savojardo, V, Fabio, G, Colombo, S, Quercioli, A, Barreca, A, Durante-Mangoni, E, Pinto, D, Incasa, E, Rizzoli, E, Vanoli, M, Casella, G, Musca, G, Cuccurullo, O, Famularo, G, Sajeva, Mr, Picardi, A, Hila, D, Rozzini, R, Giordano, A, Bonelli, A, Dentamaro, G, Gobbo, G, Cazzaniga, M, Gaudenzi, P, Giusto, L, Rizzoni, D, Castoldi, L, Mari, D, Micale, G, Altomare, E, Serviddio, G, Longhini, C, Molino, C, Deidda, S, Cuccuru, Lm, Quagliolo, M, Centenaro, Gr, Pasqui, Al, Puccetti, L, Bertolino, G, Cavallo, P, Bertolini, D, Liberato, Nl, Perciccante, A, Coralli, A, Anastasio, L, Bertucci, L, Agnelli, G, Macura, A, Morabito, C, Fava, R, Tuttolomondo, A, Di Sciacca, R, Macchini, L, Realdi, A, Fiorentini, A, Tofi, C, Cagnoni, C, Manucra, A, Romanelli, G, Cortellaro, M, Meroni, Mr, Rossi, Dp, Vergani, C., Marengoni, A, Bonometti, F, Nobili, A, Tettamanti, M, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Mannucci, PM, and Italian Society of Internal Medicine (SIMI) Investigators

Subjects
Male, Aging, Disease clusters, Pediatrics, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Hospital unit, Disease, Hospital mortality, disease clustering, Logistic regression, NO, 80 and over, Medicine, Cluster Analysis, Humans, Hospital Mortality, Aged, Aged, 80 and over, In hospital death, Medical Errors, business.industry, Clinical events, Female, Italy, REPOSI, In-hospital death, elderly patients, Odds ratio, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, elderly patient, Geriatrics and Gerontology, business, patients at risk of in-hospital death, adverse clinical events according to disease clustering
Abstract

OBJECTIVE: The aim of the study was to recognize clusters of diseases among hospitalized elderly and to identify groups of patients at risk of in-hospital death and adverse clinical events according to disease clustering. METHOD: This was a cross-sectional study conducted in 38 internal medicine and geriatric wards in Italy participating in the Registro Politerapie SIMI (REPOSI) study during 2008. The subjects were 1,332 inpatients aged 65 years or older. Clusters of diseases (i.e., two or more co-occurrent diseases) were identified using the odds ratios (OR) for the associations between pairs of conditions, followed by cluster analysis. Logistic regression models were used to evaluate the effect of disease clusters on in-hospital death and adverse clinical events. RESULTS: A total of 86.7% of the patients were discharged, 8.3% were transferred to another hospital unit, and 5.0% died during hospitalization; 36.4% of the patients had at least one adverse clinical event. Patients affected by the clusters, including heart failure (HF) and either chronic renal failure (CRF) or chronic obstructive pulmonary disease, had a significant association with in-hospital death (OR, 4.3;95% confidence interval [CI], 1.6-11.5; OR, 2.9; 95% CI, 1.1-8.3, respectively), as well as patients affected by CRF and anemia (OR, 6.1; 95% CI, 2.3-16.2). The cluster including HF and CRF was also associated with adverse clinical events (OR, 3.5; 95% CI, 1.5-7.8). The effect of both HF and CRF and anemia and CRF on in-hospital death was additive. CONCLUSION: Several groups of older patients at risk of in-hospital death and adverse clinical events were identified according to disease clustering. Knowledge of the relationship among co-occurring diseases may help developing strategies to improve clinical practice and preventative interventions.

Published
2010

17. Alleanza e cambiamento

Author

Lingiardi, Vittorio and PORZIO GIUSTO, L.

Subjects
cambiamento, alleanza terapeutica, psicoterapia
Published
2003

25. Ultrasound Characteristics of Calf Deep Vein Thrombosis and Residual Vein Obstruction After Low Molecular Weight Heparin Treatment

Author

Benilde Cosmi, Angelo Ghirarduzzi, Elisabetta Favaretto, Gualtiero Palareti, M. Iotti, L. Giusto, G. Lessiani, M. Sartori, Ludovica Migliaccio, Sartori M, Lessiani G, Favaretto E, Migliaccio L, Iotti M, Giusto L, Ghirarduzzi A, Palareti G, and Cosmi B

Subjects
Male, medicine.medical_specialty, Time Factors, Deep vein, Low molecular weight heparin treatment, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Ambulatory Care, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Enoxaparin, Mobility Limitation, Aged, Calf deep vein thrombosis, Clot diameter, Heparin, Isolated distal deep vein thrombosis, Residual venous obstruction, Whole leg ultrasound, Aged, 80 and over, Venous Thrombosis, Leg, Ultrasonography, Doppler, Duplex, business.industry, Ultrasound, Remission Induction, Anticoagulants, Reproducibility of Results, Reduced mobility, Heparin, Middle Aged, medicine.disease, Thrombosis, Surgery, medicine.anatomical_structure, Treatment Outcome, Vein obstruction, Italy, ROC Curve, Area Under Curve, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug, Lateral gastrocnemius
Abstract

Calf deep vein thrombosis (CDVT) ultrasound diagnostic criteria are still debated. A clot >= 3.5 mm may be an appropriate threshold for CDVT diagnosis. Six week heparin treatment is associated with recanalization in half of patients with CDVT. Objective/Background: Calf deep vein thrombosis (CDVT) is frequently found in symptomatic outpatients, but CDVT ultrasound diagnostic criteria are still debated. It has been proposed that only clots with >= 5 mm maximum diameter can be considered as CDVT. Aims: To assess clot diameters and characteristics of CDVT, and to assess the recanalization rate of CDVT after anticoagulant treatment. Methods: In a prospective, multicenter cohort study symptomatic outpatients in whom CDVT was diagnosed by ultrasound were enrolled. Posterior tibial, fibular, medial and lateral gastrocnemius, and soleal veins were compressed transversally over their entire length. Clot diameter was measured during maximum compression and ultrasound was repeated after 6 weeks of low molecular weight heparin treatment. Results: In 172 patients (age 70 +/- 1 y, male 32%) CDVT was detected in 132 (76.7%) muscle veins only, and in 24 (14%) axial veins only, while 16 (9.3%) patients had both muscular and axial CDVT. A total of 212 clots were found with a diameter of 5.8 +/- 1.8 mm (IQR 4.5-6.8 mm) with the 10th percentile being >= 3.5 mm. A cut off value of >= 5 mm had a sensitivity of 0.76 (95% CI 0.69-0.82), whereas a value of >= 3.5 mm had a sensitivity of 0.94 (95% CI 0.89-0.97). Recanalization (i.e. residual vein obstruction = 5 mm is found in only 76% of CDVT patients and a clot diameter >= 3.5 mm may be more appropriate as a threshold for CDVT. After 6 weeks of anticoagulant treatment, half of CDVT patients had recanalization and recanalization was not correlated with clot characteristics at enrolment, but with mobility of the patients. (C) 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Published
2016

26. Two-year Pivotal Study Analysis of the Safety and Efficacy of Implantable Tibial Nerve Stimulation With eCoin® for Urgency Urinary Incontinence.

Author

Lucente V, Giusto L, and MacDiarmid S

Subjects
Humans, Female, Prospective Studies, Male, Middle Aged, Aged, Treatment Outcome, Urinary Bladder, Overactive therapy, Time Factors, Adult, Tibial Nerve, Urinary Incontinence, Urge therapy, Electric Stimulation Therapy adverse effects, Electric Stimulation Therapy methods, Electric Stimulation Therapy instrumentation
Abstract

Objective: To evaluate the continued effectiveness and safety of the eCoin Implantable Tibial Nerve Stimulator system (ITNS) for urgency urinary incontinence (UUI) in patients with overactive bladder (OAB). The 1-year pivotal study was extended through 2 years. The ITNS is a novel and recently FDA-approved therapy., Methods: A prospective, multicenter, single-arm trial was conducted on 137 subjects with refractory UUI to evaluate eCoin ITNS therapy. A 3-day voiding diary was collected along with the OAB questionnaire, Patient Global Impression of Improvement, and a custom Likert scale on subject satisfaction. The primary efficacy measure was the proportion of subjects who achieved at least 50% reduction from baseline in number of UUI episodes. The primary safety measure was device-related adverse events (AEs)., Results: Seventy-two subjects completed the 96-week evaluation. Around 78% (95% CI: 67%-87%) experienced at least 50% reduction in UUI episodes; 48% (95% CI, 36%-60%) experienced at least 75% reduction, and 22% (95% CI, 13%-33%) were dry on a 3-day diary. Subjects reported a decrease from baseline in their UUI episodes/day of 2.61 (SD 2.97) and 2.97 (SD 2.64) at 48 weeks and 96 weeks, respectively. Around 91.3% did not require additional medications for OAB. No serious or unanticipated AEs were reported in this extension phase., Conclusion: The eCoin ITNS demonstrated consistent continuing effectiveness and safety in treating OAB patients with UUI. The findings support it as an excellent treatment option for refractory patients., Competing Interests: Declaration of Competing Interest Dr Vincent Lucente, Paid consultant to Sponsor; Study Investigator Funded by Sponsor; Stock Holder for Valencia Technologies; Dr Laura Giusto, Financial Relationship to Competitors-Proctor for Bluewind; Primary Investigator of Medtronic TITAN trial; Dr Scott MacDiarmid: Paid consultant to Sponsor; Study Investigator Funded by Sponsor; Stock Holder for Valencia Technologies., (Copyright © 2024. Published by Elsevier Inc.)

Published
2024
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27. Two-Year Efficacy and Safety Outcomes of the Pivotal OASIS Study Using the Revi System for Treatment of Urgency Urinary Incontinence.

Author

Heesakkers JPFA, Toozs-Hobson P, Sutherland SE, Digesu A, Amundsen CL, McCrery RJ, De Wachter S, Kean ER, Martens F, Benson K, Ferrante KL, Cline KJ, Padron OF, Giusto L, Lane FL, Witte LPW, and Dmochowski RR

Abstract

Purpose: The BlueWind Medical Device, Revi, is a novel implantable tibial neuromodulation system powered by an external, battery-operated wearable that facilitates individually tailored stimulation to provide treatment for urgency urinary incontinence (ie, overactive bladder wet). The Revi System is the first Food and Drug Administration-cleared implantable neuromodulation device which can be used without prior failure with more conservative treatment options. Two-year follow-up results of the OASIS study are presented., Materials and Methods: The Revi System was implanted in 151 female participants. The primary efficacy and safety endpoints were assessed at 6 and 12 months, after which participants either consented to extend follow-up for long-term assessment of treatment durability and safety or they chose to exit the study., Results: Ninety-seven participants completed the 24-month assessment, and of these, 79% were therapy responders (≥50% reduction in urgency urinary incontinence episodes, demonstrated on a 3-day voiding diary). Importantly, therapeutic response was durable, with comparable effectiveness at 6, 12, and 24 months (response rates of 78%, 82%, and 79%, respectively). Participants who completed both the 6- and 24-month assessment had similar demographics and treatment results at the 6-month visit, indicating that these results at 24 months are representative of the overall study population. In addition, high satisfaction and patient impression of improvement were reported, with 97% (88/91) of the participants satisfied with the therapy and 80% (78/97) feeling "much better" or "very much better." There were no serious adverse events related to the device or the procedure through 24 months., Conclusions: Two-year results demonstrate durable efficacy, high patient satisfaction, and a very favorable safety profile., Trial Registration: Clinicaltrials.gov Identifier: NCT03596671.

Published
2024
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28. A prospective study to assess the effectiveness and safety of the BlueWind System in the treatment of patients diagnosed with urgency urinary incontinence.

Author

Heesakkers JPFA, Toozs-Hobson P, Sutherland SE, Digesu A, Amundsen CL, McCrery RJ, De Wachter S, Kean ER, Martens F, Benson K, Ferrante KL, Cline KJ, Padron OF, Giusto L, Lane FL, and Dmochowski RR

Subjects
Humans, Female, Middle Aged, Prospective Studies, Aged, Treatment Outcome, Electric Stimulation Therapy adverse effects, Electric Stimulation Therapy instrumentation, Adult, Implantable Neurostimulators adverse effects, Urinary Bladder, Overactive therapy, Urinary Bladder, Overactive physiopathology, Urinary Bladder, Overactive diagnosis, Tibial Nerve physiopathology, Urinary Incontinence, Urge therapy, Urinary Incontinence, Urge physiopathology, Urinary Incontinence, Urge diagnosis
Abstract

Background: Overactive bladder (OAB) affects one in six adults in Europe and the United States and impairs the quality of life of millions of individuals worldwide. When conservative management fails, third-line treatments including tibial neuromodulation (TNM) is often pursued. TNM has traditionally been accomplished percutaneously in clinic., Objective: A minimally invasive implantable device activated by a battery-operated external wearable unit has been developed for the treatment of urgency urinary incontinence (UUI), mitigating the burden of frequent clinic visits and more invasive therapies that are currently commercially available., Methods: A prospective, multicenter, single-arm, open-label, pivotal study evaluated the safety and effectiveness of the device in adult females with UUI (i.e., wet OAB) (BlueWind Implantable Tibial Neuromodulation [iTNM] system; IDE number #G200013; NCT03596671). Results with the device were previously published under the name RENOVA iStim, which has been since renamed as the Revi™ System. Approximately 1-month post-implantation of the device, participants delivered therapy at their convenience and completed a 7-day voiding diary before visits 6- and 12-months post-treatment initiation. The primary efficacy and safety endpoints were the proportion of responders to therapy ( ≥ 50% improvement on average number of urgency-related incontinence episodes) and incidence of adverse events from implantation to 12-month post-activation., Results: A total of 151 participants, mean age 58.8 (SD: 12.5), were implanted; 144 and 140 completed the 6- and 12-month visits, respectively. The participants demonstrated mean baseline of 4.8 UUI/day (SD 2.9) and 10 voids/day (SD 3.3). Six and 12-months post-activation, 76.4% and 78.4% of participants, respectively, were responders to therapy in an intent-to-treat analysis. Of the 139 participants with completed 12-month diaries, 82% were responders, 50% were classified as "dry" (on at least 3 consecutive diary days), and 93.5% of participants reported that their symptoms improved. No implanted participant experienced an SAE related to the procedure or device., Conclusions: iTNM, delivered and powered by a patient-controlled external wearable communicating with an implant, demonstrated clinically meaningful and statistically significant improvement in UUI symptoms and a high safety profile. This therapy highlights the value of patient-centric therapy for the treatment of UUI., (© 2024 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.)

Published
2024
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29. Multi-institution analysis of racial disparity among African-American men eligible for prostate cancer active surveillance.

Author

Dinizo M, Shih W, Kwon YS, Eun D, Reese A, Giusto L, Trabulsi EJ, Yuh B, Ruel N, Marchalik D, Hwang J, Kundu SD, Eggener S, and Kim IY

Abstract

There is a significant controversy on whether race should be a factor in considering active surveillance for low-risk prostate cancer. To address this question, we analyzed a multi-institution database to assess racial disparity between African-American and White-American men with low risk prostate cancer who were eligible for active surveillance but underwent radical prostatectomy. A retrospective analysis of prospectively collected clinical, pathologic and oncologic outcomes of men with low-risk prostate cancer from seven tertiary care institutions that underwent radical prostatectomy from 2003-2014 were used to assess potential racial disparity. Of the 333 (14.8%) African-American and 1923 (85.2%) White-American men meeting active surveillance criteria, African-American men were found to be slightly younger (57.5 vs 58.5 years old; p = 0.01) and have higher BMI (29.3 v 27.9; p < 0.01), pre-op PSA (5.2 v 4.7; p < 0.01), and maximum percentage cancer on biopsy (15.1% v 13.6%; p < 0.01) compared to White-American men. Univariate and multivariate analysis demonstrated similar rates of upgrading, upstaging, positive surgical margin, and biochemical recurrence between races. These results suggest that single institution studies recommending more stringent AS enrollment criteria for AA men with a low-risk prostate cancer may not capture the complete oncologic landscape due to institutional variability in cancer outcomes. Since all seven institutions demonstrated no significant racial disparity, current active surveillance eligibility should not be modified based upon race until a prospective study has been completed., Competing Interests: CONFLICTS OF INTEREST None.

Published
2018
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30. Prevention of iatrogenic ureteral injuries during robotic gynecologic surgery: a review.

Author

Lee Z, Kaplan J, Giusto L, and Eun D

Subjects
Coloring Agents, Cystoscopy, Female, Humans, Indocyanine Green, Intraoperative Complications prevention & control, Preoperative Care, Stents, Ureter injuries, Fluorescence, Gynecologic Surgical Procedures, Iatrogenic Disease prevention & control, Intraoperative Care, Robotic Surgical Procedures, Ureter diagnostic imaging
Abstract

Iatrogenic ureteral injuries, more than half of which occur during gynecologic surgery, may have devastating consequences for both patients and physicians. Gynecologists have employed various techniques such as cystoscopy, ureteral stents, and lighted ureteral stents to prevent ureteral injuries. The emergence and increasing prevalence of robotic surgery necessitates that we not only reevaluate the utility of these techniques, but also develop new ones specific for the robotic modality. In the robotic setting, the surgeon lacks tactile feedback and must rely primarily on visual cues. The use of intraureteral indocyanine green and subsequent visualization under near-infrared fluorescence appears to be a promising technique to primarily and secondarily prevent ureteral injuries during robotic gynecologic surgery., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Published
2016
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31. Use of indocyanine green during robot-assisted ureteral reconstructions.

Author

Lee Z, Moore B, Giusto L, and Eun DD

Subjects
Adult, Aged, Aged, 80 and over, Humans, Injections, Intraoperative Care, Middle Aged, Retrospective Studies, Treatment Outcome, Young Adult, Fluorescent Dyes administration & dosage, Indocyanine Green administration & dosage, Plastic Surgery Procedures methods, Robotic Surgical Procedures methods, Ureter surgery, Urologic Surgical Procedures methods
Abstract

Background: Although there are reports of robot-assisted ureteral reconstructions (RURs) with excellent safety and efficacy, the procedures remain technically challenging. In the robotic setting the surgeon must rely on visual cues in the absence of tactile feedback. Indocyanine green (ICG) is a dye that can be visualized under near-infrared fluorescence (NIRF)., Objective: To describe our novel technique, which utilizes intraureteral injection of ICG and subsequent visualization under NIRF to facilitate RUR, and report our outcomes after these procedures., Design, Setting, and Participants: This is a retrospective review of 25 patients who underwent 26 RURs for various ureteral pathologies between June 2012 and October 2013., Surgical Procedure: After full disclosure, all patients consented to off-label use of ICG. A ureteral catheter and/or percutaneous nephrostomy tube were used to inject 10ml of ICG into the diseased ureter, above and below the stricture. Intraoperatively, NIRF was activated to assist in identification of the ureter and to localize the margins of ureteral strictures., Measurements: Postoperatively, RURs were assessed for clinical success (absence of symptoms attributable to ureteral pathology) and radiological success (absence of a ureteral stricture on imaging)., Results and Limitations: Our technique provided visual cues and aided in successful performance of 26 RURs in 25 patients. The procedures included ureterolysis (n=4), pyeloplasty (n=8), ureteroureterostomy (n=9), and ureteroneocystostomy (n=5). There were no perioperative complications attributable to ICG use. At a mean overall follow-up of 12 mo, all procedures were clinically and radiologically successful. This study is limited by the small sample size and short-term follow-up., Conclusions: Intraureteral injection of ICG and subsequent visualization under NIRF facilitates RUR by aiding in rapid and accurate identification of the ureter, and precise localization of the proximal and distal ureteral stricture margins. In our experience, our technique is safe, easy to perform, and reproducible., Patient Summary: In this report, we describe a new technique to facilitate robot-assisted ureteral reconstructions using intraureteral injection of ICG and subsequent visualization under near-infrared fluorescence. More specifically, our technique allows for rapid and accurate identification of the ureter, and precise localization of ureteral strictures., (Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Published
2015
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32. New developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome.

Author

Pontari M and Giusto L

Subjects
Adrenergic alpha-Antagonists therapeutic use, Chronic Disease, Disease Management, Female, Humans, Male, Pelvic Pain psychology, Prostatitis psychology, Psychological Techniques, Syndrome, Treatment Outcome, Pelvic Pain diagnosis, Pelvic Pain therapy, Prostatitis diagnosis, Prostatitis therapy
Abstract

Purpose of Review: To describe new developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome (CPPS)., Recent Findings: Symptoms in men with chronic prostatitis/CPPS appear to cluster into a group with primarily pelvic or localized disease, and a group with more systemic symptoms. Several other chronic pain conditions can be associated with chronic prostatitis/CPPS, including irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome. Markers of neurologic inflammation and autoimmune disease parallel changes in symptoms after treatment. Treatment options include new alpha-blockers, psychological intervention, and prostate-directed therapy. The areas of acupuncture and pelvic floor physical therapy/myofascial release have received increased recent attention and appear to be good options in these patients. Future therapy may include antibodies to mediators of neurogenic inflammation and even treatment of bacteria in the bowel., Summary: The diagnosis of chronic prostatitis/CPPS must include conditions traditionally outside the scope of urologic practice but important for the care of men with chronic pelvic pain. The treatment is best done using multiple simultaneous therapies aimed at the different aspects of the condition.

Published
2013
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33. Immunosuppressive activity of a purified spleen extract (lymphocytic chalone?) is not due to polyamines spermine and spermidine.

Author

Lenfant M, di Giusto L, Oleson DL, Garcia-Giralt E, Mayadoux E, Villanueva V, and Adlakha RC

Subjects
Animals, DNA biosynthesis, Dermatitis, Contact immunology, Growth Inhibitors, Hemolytic Plaque Technique, Mice, Mice, Inbred DBA, Thymidine metabolism, Tissue Extracts pharmacology, Immunosuppression Therapy, Spermidine immunology, Spermine immunology, Spleen immunology
Abstract

Spermine, spermidine and a purified spleen extract (PSE) have been compared in vivo in these three tests: hemolytic plaque forming capacity in sensitized mice, delayed hypersensitivity reaction and 3H-thymidine incorporation into various tissue cells. The results obtained demonstrated that the immunosuppressive activity of PSE cannot be attributed to those polyamines. Ion exchange analysis of PSE before and after acid hydrolysis confirmed the absence of free and/or bound polyamines in the studied extract.

Published
1979

35. Purification of immunosuppressive factors extracted from bovine spleen (lymphoid chalone).

Author

Lenfant M, Garcia-Giralt E, Thomas M, and Di Giusto L

Subjects
Animals, Cattle, Chromatography, Culture Techniques, DNA biosynthesis, Growth Inhibitors immunology, Immunosuppression Therapy, Lymphocyte Activation, Lymphocytes metabolism, Mice, Ultrafiltration, Growth Inhibitors isolation & purification, Spleen analysis
Abstract

A low molecular weight immunosuppressive factor FA which is able to reduce the blastic transformation capacity of lymphoid cells from treated mice has been characterized. It was prepared from a bovine spleen acetone powder and found to be associated partly with high molecular weight carriers in the form of an active complex characterized previously as part of a 'lymphoid chalone' fraction. FA may be obtained by selective ultrafiltration of F followed by P-2 Biogel chromatography of the ultrafiltrate. Thymidine, deoxyinosine and deoxycytidine have been identified as the major constituents of FA by mass spectrometry, ultraviolet absorption data and thin layer chromatography. However, none of these nucleotides has the biological activity of FA.

Published
1978
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36. The purification of an immunosuppressive factor extracted from bovine spleen--III. Purification process.

Author

Lenfant M, Garcia-Giralt E, Di Giusto L, and Thomas M

Subjects
Animals, Cattle, Chromatography, Chromatography, High Pressure Liquid, Chromatography, Thin Layer, Dose-Response Relationship, Immunologic, Hemolytic Plaque Technique, Immunosuppressive Agents pharmacology, Mice, Molecular Weight, Immunosuppressive Agents isolation & purification, Spleen immunology
Published
1980
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